Immigration reduces time in the doctor's waiting room

Despite all the public hype about how our national health system is creaking with the weight of an immigrant influx, new evidence suggests that waiting times for outpatients are actually reduced in areas with relatively high immigrant populations. Furthermore, there is no evidence of an increase in waiting times in A&E (accident and emergency) and in elective care.

A new Working Paper published by the Blavatnik School of Government brings fresh evidence to the debate about the impacts of immigration on Britain’s National Health Service. While previous papers analysed the effect of immigration to the UK on welfare use, and documented differences between foreign born and natives in health care use, we know less about the effects of immigration on NHS waiting times, which is one of the most pressing issues of the NHS system.

For this research, the authors used immigration data from 141 local authorities in England merged with administrative information drawn from the Hospital Episode Statistics, which processes over 125 million admitted patient, outpatient and accident and emergency records each year.

Their findings may be surprising to those who have suggested that increased immigration is a key factor contributing to the rise in A&E waiting times.

The analysis of their data shows that immigration actually reduced waiting times for outpatient referrals. On average, a 10 percentage points increase in the share of migrants living in a local authority would reduce waiting times by 9 days. The authors find no evidence that immigration affects waiting times in A&E and in elective care. Their research does reveal, however, that the effects can be very different in deprived areas: they observed that native internal migration (often triggered by immigration inflows) does increase NHS waiting times.

The authors also provide likely explanation factors for their findings in the Working Paper. They suggest their findings are likely driven by two key factors. First, migrants tend to be young and healthy upon arrival ("healthy immigrant effect") and likely to have a smaller impact on the demand for NHS services. Second, the arrival of immigrants increases the likelihood of natives moving and accessing health services in a different local authority. Thus, the effects of immigration on the demand for health care services are dispersed throughout the country (via internal migration).

Their research aims to build a better understanding of the relationship between immigration and the NHS. 

Download "The Effects of Immigration on NHS Waiting Times"

The authors of the Working Paper are:

  • Osea Giuntella, Blavatnik School of Government, Blavatnik School of Government
  • Catia Nicodemo, Centre for Health Service Economics and Organisation, University of Oxford
  • Carlos Vargas Silva, Centre on Migration, Policy and Society, University of Oxford